Payer: Page 192
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Kindred Healthcare doles out $125M to settle Medicare scheme allegations
The organization allegedly provided unneeded therapy services to nursing home patients.
By Nina Flanagan • Jan. 14, 2016 -
KPMG: Healthcare M&A activity projected to be among top sectors through 2016
A survey showed healthcare is projected to be the third most active sector for M&A through 2016, following the technology and biopharma sectors.
By Nina Flanagan • Jan. 14, 2016 -
State attorneys general work with DOJ to review pending mega-mergers
Additional scrutiny may make it harder for the industry's two largest mergers to get approval.
By Heather Caspi • Jan. 13, 2016 -
Deep Dive
Will AHIP survive major payer departures?
With the changing landscape of health insurance comes change in industry representation.
By Heather Caspi • Jan. 13, 2016 -
Late enrollments destabilizing market, insurers say
The Obama administration is addressing concerns special enrollment periods may be subject to abuse.
By Heather Caspi • Jan. 13, 2016 -
Kentucky governor makes good on vow to shutter state insurance exchange
Bevin has already halted marketing for Kynect.
By Meg Bryant • Jan. 13, 2016 -
Late sign-ups for ACA plans get tighter limits
Highly promoted late-enrollment opportunities are now being scaled back.
By Heather Caspi • Jan. 13, 2016 -
Louisiana Gov. Edwards signs order to expand Medicaid
The governor, sworn in this Monday, wasted no time signing an executive order that will make 300,000 state residents eligible for the program.
By Jeff Byers • Jan. 13, 2016 -
Biggest U.S. nonprofit health system embraces transparent pricing
The move by Ascension’s St. John Health System reveals true cost more than ever.
By Heather Caspi • Jan. 13, 2016 -
Report: Disadvantaged population can impact hospital's performance
The findings are likely to intensify debate among those who argue social factors in risk adjustment enables lower-quality care for riskier patients and reduces incentives to improve.
By Meg Bryant • Jan. 13, 2016 -
U.S. task force finalizes breast screening recs, muddies guideline waters
The recommendations put the government at odds with American Cancer Society guidelines issued last October.
By Meg Bryant • Jan. 13, 2016 -
21 participants join new Next Generation ACO program
Allowing up to 100% financial risk, the new model includes a prospectively set benchmark and offers beneficiaries the choice to be aligned to the ACO.
By Heather Caspi • Jan. 12, 2016 -
Hospitals continue to file lawsuits against HHS' two-midnight rule
Last Friday, more than 50 hospitals filed a lawsuit against HHS Secretary Sylvia Burwell over the controversial measure.
By Nina Flanagan • Jan. 12, 2016 -
Humana says membership, revenue to drop this year
The insurer expects 300,000 members will drop their insurance coverage by the end of the year.
By Nina Flanagan • Jan. 12, 2016 -
Idaho governor announces alternative plan to Medicaid expansion
State legislators support addressing the coverage gap, but not via the ACA.
By Heather Caspi • Jan. 11, 2016 -
UnitedHealth warns N.Y. of low rates following state's co-op failure
The insurer is taking issue with state regulators for factoring risk-adjustment payments into rate limits.
By Heather Caspi • Jan. 11, 2016 -
Deep Dive
Friday Rounds: Wheelin', dealin' and leavin' in the new year
The healthcare industry didn't waste any time kicking off the new year. Federal actions framed the week as one major insurer left the trade group AHIP.
By Jeff Byers • Jan. 8, 2016 -
LA governor sets ambitious plan for Medicaid expansion
Despite budget issues, the incoming democratic leader is targeting a summer expansion deadline.
By Heather Caspi • Jan. 8, 2016 -
Federal watchdog warns of waste, lack of controls in ACA tax credit payment program
In response, CMS is pilot testing an automated process to address tax credit payments concerns.
By Meg Bryant • Jan. 7, 2016 -
Americans struggle to pay health bills even when insured
More than a quarter of insured Americans in a recent survey said unexpected claim denials made it difficult to pay medical bills.
By Meg Bryant • Jan. 7, 2016 -
Health Affairs Blog: Standardized option for plans may benefit consumers, reduce discrimination
Standardized options would provide fixed deductibles, out-of-pocket limits, and standard copays and coinsurance for a number of essential health benefit services.
By Nina Flanagan • Jan. 7, 2016 -
Montgomery County Planning Commission
AHIP suffers major blow as Aetna departs
The company will not renew membership for 2016, marking a second hit to AHIP after United Health left last summer.
By Heather Caspi • Jan. 6, 2016 -
California approved for $6.2B Medicaid waiver
The state will be able to continue the massive transformation of its state Medicaid program.
By Heather Caspi • Jan. 6, 2016 -
Critical illness plans fill voids of skimpy health plans
Lump sum deals are being used to supplement otherwise high cost plans.
By Heather Caspi • Jan. 6, 2016 -
HIPAA rule change aims to limit gun access
HHS’ HIPAA privacy rule update will allow mental health providers to identify patients subject to a mental health prohibitor barring them from shipping, transporting, or possessing firearms.
By Meg Bryant • Jan. 6, 2016
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